Terms and Conditions
1. Definitions
- Affiliate: Refers to any other entity directly or indirectly controlled by, or under common control with, the client.
- Authorized Providers: The number of physicians and physician extenders authorized to use the RCM services.
- Authorized Rooms: The number of rooms authorized for use in conjunction with RCM services.
- Billing Implementation Fee: The fee for implementing billing services.
- Billing Information: Includes patient demographics, insurance details, service dates, CPT codes, ICD-9/ICD-10 codes, and other necessary information for reimbursement.
- Client Data: Electronic data related to patients, entered into the ModMed Software.
2. Services
- We provide expert medical billing and coding services to optimize revenue for healthcare providers.
- Our team submits claims accurately and efficiently, follows up on pending claims, and appeals denied or underpaid claims.
- Coding experts ensure precise codes for optimal reimbursement.
- We audit all claims for accuracy and compliance.
3. Responsibilities
- The client agrees to provide complete and accurate billing information promptly.
- We maintain confidentiality and security of client data.
- The client is responsible for authorized providers and rooms.
- Billing implementation fees are outlined in Schedule “B.”
4. Payment
- Fees are invoiced as per the RCM Agreement.
- Payment terms are specified in the agreement.
- Late payments may incur additional charges.
5. Termination
- Either party may terminate the agreement with notice.
- Upon termination, client data will be returned or securely disposed of.
6. Miscellaneous
- These terms and conditions were last updated on June 1, 2021.
- Any disputes will be resolved according to the RCM Agreement.